老年2型糖尿病合并急性脑梗死患者血清IGF-1水平与神经功能及颈动脉斑块的关系

摘要

Objective To study relationship between the level of serum IGF-1 in elderly patients with type 2 diabetes mellitus combined with acute cerebral infarction,neurological function and carotid artery plaque.Methods 60 elderly patients with type 2 diabetes mellitus combined with acute cerebral infarction treated in our hospital were selected as the research object from June 2014 to October 2015.According to the severity of atherosclerosis,the patients were divided into three groups:10 cases in no plaque group,22 cases in stable plaque group,28 cases in unstable plaque group.40 cases of elderly patients with acute cerebral infarction were chosen as the disease control group;40 healthy elderly people were selected as healthy control group.The level of IGF-1 was detected by ELISA.The U.S.National Institutes of Health Stroke Scale (NIHSS) neurological assessment was performed at 1 week and 2 weeks.The modified Rankin table (MRS) was assessed at 90 days.Results Diabetes combined with cerebral infarction group has the lower IGF-1 level than cerebral infarction group and control group at 1 week or 2 weeks.Patients in cerebral infarction group has the higher IGF-1 level than the control group,the difference was statistically significant (P＜0.05).NIHSS scores of diabetes complicated with cerebral infarction patients were higher than those in patients with cerebral infarction at 1 week or 2 weeks,the difference is statistically significant (P ＜0.05).MRS scores were higher in cerebral infarction group than cerebral infarction group at 90ds,the difference is statistically significant (P ＜0.05).In diabetes complicated with cerebral infarction patients,the serum level of IGF-1 and NIHSS score showed a negative correlation (r =-0.561,P =0.006;r =-0.672,P =0.000) at 1 week,2 weeks.In diabetes complicated with cerebral infarction patients,the serum level of IGF-1 and MRS score showed negative correlation (r =-0.426,P =0.016;r =-0.445,P =0.009) at 1 week,2 weeks.With the aggravation of diabetes and atherosclerotic plaque of carotid artery in patients with cerebral infarction severity and serum level of IGF-1 decreased (P＜0.05).Conclusion Serum IGF-1 in elderly patients with type 2 diabetes complicated with cerebral infarction patients showed abnormal expression.IGF-1 levels in elderly patients with type 2 diabetes complicated with cerebral infarction are closely related with neurological deficit and carotid artery plaque severity.%目的 探讨老年2型糖尿病合并急性脑梗死患者血清胰岛素生长因子-1(insulin-like growth factor-1,IGF-1)水平与神经功能及颈动脉斑块的关系.方法 选择2014年6月～2015年10月期间被我院神经内科收治的60例老年2型糖尿病并急性脑梗死患者为研究对象,60例老年2型糖尿病并急性脑梗死患者中,按照动脉粥样硬化严重程度不同分为:无斑块10例,稳定斑块22例,不稳定斑块28例.选择40例老年急性脑梗死患者作为疾病对照组;选老年健康者40名为健康对照组.采用双抗夹心法酶联免疫吸附试验(ELISA法)检测IGF-1水平.采用美国国立卫生院卒中量表(NIHSS)于发病1周、2周时行神经功能评估;采用改良Rankin量表(MRS)于90 d时行神经功能评估.结果 糖尿病合并脑梗死组1周、2周时IGF-1水平均低于脑梗死组和对照组,而脑梗死组IGF-1水平高于对照组,差异有统计学意义(P＜0.05).1周、2周时糖尿病合并脑梗死患者NIHSS评分均高于脑梗死组患者(P＜0.05);糖尿病合并脑梗死组患者90 dMRS评分高于脑梗死组患者(P＜0.05).1周、2周时糖尿病合并脑梗死患者血清IGF-1水平与NIHSS评分均呈负相关(r=-0.561,P=0.006,r=-0.672,P=0.000);1周、2周时糖尿病合并脑梗死患者血清IGF-1水平与MRS评分均呈负相关(r=-0.426,P=0.016,r=-0.445,P=0.009).随着糖尿病合并脑梗死患者颈动脉斑块严重程度的加重,血清IGF-1水平呈下降趋势(P＜0.05).结论 IGF-1在老年2型糖尿病合并脑梗死患者外周血血清中呈现异常表达,IGF-1水平与老年2型糖尿病合并脑梗死的神经功能缺损及颈动脉斑块严重程度密切相关.